RESUMO
The increasing use of high-resolution computed tomography in formerly asbestos-exposed workers requires valid diagnostic criteria for the findings which have to be reported as suspicious for being asbestos-related in surveillance programmes and for the assessment of causal relationships between former asbestos exposure and findings in computed tomography. The present article gives examples for asbestos-related findings in HR-CT and discusses the specificity of parenchymal and pleural changes due to asbestos fibres.
Assuntos
Amianto/análise , Asbestose/diagnóstico , Asbestose/epidemiologia , Prova Pericial/estatística & dados numéricos , Pulmão/diagnóstico por imagem , Vigilância da População/métodos , Tomografia Computadorizada por Raios X/estatística & dados numéricos , Causalidade , Alemanha/epidemiologia , Humanos , Programas de Rastreamento/métodos , Programas de Rastreamento/estatística & dados numéricos , Medição de Risco/métodos , Fatores de RiscoRESUMO
Asbestos-related diseases still play an important role in occupational medicine. The detection of benign asbestos-related diseases is one condition for the compensation of asbestos-related lung cancer in Germany. Due to the increasing use of computed tomography, asbestos-related diseases are more frequently detected in the early stages. The present article proposes recommendations for the findings which have to be reported as suspicious for being asbestos-related based on a) chest X-rays and b) computed tomography using the International Classification System for Occupational and Environmental Respiratory Diseases (ICOERD).
Assuntos
Asbestose/diagnóstico por imagem , Formulário de Reclamação de Seguro/normas , Seguro de Acidentes/normas , Guias de Prática Clínica como Assunto , Radiografia Torácica/normas , Tomografia Computadorizada por Raios X/normas , Alemanha , HumanosRESUMO
The classification of pneumoconiosis according to ILO standard - comparing a X-ray of the lung with ILO radiographs - is well established in Germany. The extension of digital imaging is a challenging task in occupational medicine as well as in pneumology. Technical requirements are not known sufficiently and the necessary equipment is not well distributed. This paper describes the current position on recording, assessment and documentation of digital imaging of the lung and pleura.
Assuntos
Pneumoconiose/diagnóstico por imagem , Guias de Prática Clínica como Assunto , Intensificação de Imagem Radiográfica/normas , Radiografia Torácica/normas , Alemanha , HumanosRESUMO
The melting transition of Ce adatom superlattices stabilized by long-range substrate-mediated electronic interactions on Cu(111) and Ag(111) noble metal surfaces has been investigated by low-temperature scanning tunneling microscopy, density functional theory calculations, and kinetic Monte Carlo simulations. Intriguingly, owing to the interaction between Ce adatoms and substrate, these superlattices undergo two-dimensional melting to a liquid without transition through the hexatic phase. The crucial parameters for this direct solid to liquid transition are identified.
RESUMO
The ILO (1980) Classification has been revised during recent years. The new version is now available as the International Classification of Radiographs of Pneumoconioses (Revised edition 2000). The Guidelines booklet is currently available only in English. Those involved felt it was important to maintain continuity with the ILO (1980) edition, in particular to retain the standard radiographs, despite their restricted quality, so as to ensure comparability with earlier national and international data sets. The standard films illustrating pleural abnormalities, and 'u'-shadows, have been modified and reconstituted. The most important changes relate to assessment of film quality, pleural abnormalities, and additional symbols. In Germany, film quality is characterised as "+", "+-", "+--" and "u" according to whether the ability to assess pneumoconiosis is judged to be unimpeachable ("+") to unusable ("u"). If a film is not classified as "+", then written comments regarding defects are required. For "diffuse" pleural thickening, the ILO (2000) edition now requires the presence also of obliteration of the costophrenic angle. This was not required in the earlier (1980) edition and, as previously, is also not stipulated in the German version. A minimum width of 3 mm (previously 0-5 mm), coded "a", is required both for plaques as well as for the margin to the lateral chest wall. Congruence is thus achieved for criteria, which, in German practice, lead to an indication of suspect occupational disease. Plaques on the diaphragm are not considered for measurement of extent; they are only coded as present or absent. If calcification is identified, then this must also be classified and measured as a localised plaque. Extent of calcification on its own, previously coded "0" to "3", is no longer specified. The following new symbols, illustrated by new diagrams, have been introduced: aa = atherosclerotic aorta; at = apical thickening; cg = calcified granuloma (or other non-pneumocononiotic nodules); me = mesothelioma (already previously differentiated from "ca" on the German record sheet); pa = plate atelectasis; pb= parenchymal bands; ra = rounded atelectasis; od = other disease. (Examples of the latter are illustrated diagrammatically by lobar pneumonia, aspergilloma, goiter and hiatal hernia.) Earlier national differences (ILO 1980/German Federal Republic) on particular issues have also been agreed among German "double-readers" ["Zweitbeurteiler"]. However, conformity between the original (ILO 2000) text and the national (German) modified text has been retained in large measure. The detailed descriptions of the standard films differ in certain respects from the German (1980) definitions. Some revision of individual descriptions of the films are proposed. Except for a few differences, agreement was reached here too. The definitive date for the change in Germany is expected to be in early 2004. The standard films are already available now through ILO offices in Geneva or Bonn (addresses in appendix.)
Assuntos
Pneumoconiose/classificação , Pneumoconiose/diagnóstico por imagem , Radiografia/normas , Alemanha , Humanos , Pleura/diagnóstico por imagem , Garantia da Qualidade dos Cuidados de SaúdeRESUMO
The electronic structure and morphology of ultrathin MgO films epitaxially grown on Ag(001) were investigated using low-temperature scanning tunneling spectroscopy and scanning tunneling microscopy. Layer-resolved differential conductance (dI/dU) measurements reveal that, even at a film thickness of three monolayers, a band gap of about 6 eV is formed corresponding to that of the MgO(001) single-crystal surface. This finding is confirmed by layer-resolved calculations of the local density of states based on density functional theory.
Assuntos
Doenças dos Trabalhadores Agrícolas/etiologia , Pneumopatias Obstrutivas/etiologia , Doenças dos Trabalhadores Agrícolas/diagnóstico , Diagnóstico Diferencial , Poeira/efeitos adversos , Humanos , Pneumopatias Obstrutivas/diagnóstico , Exposição Ocupacional/efeitos adversos , Fatores de RiscoRESUMO
The tip-surface region of a scanning tunneling microscope (STM) emits light when the energy of the tunneling electrons is sufficient to excite luminescent processes. These processes provide access to dynamic aspects of the local electronic structure that are not directly amenable to conventional STM experiments. From monolayer films of carbon-60 fullerenes on gold(110) surfaces, intense emission is observed when the STM tip is placed above an individual molecule. The diameter of this emission spot associated with carbon-60 is approximately 4 angstroms. These results demonstrate the highest spatial resolution of light emission to date with a scanning probe technique.
RESUMO
This review deals with methodological features and the corresponding argumentation of a screening test for non-specific bronchial provocation with acetylcholine as it was standardized in the eastern part of Germany. This test has shown its suitability, whereby it has to be mentioned critically that the low provocation dose detects only higher grades of hyperreactivity. On the other hand the relevance of the test could be proved especially in occupational health follow-up studies.
Assuntos
Acetilcolina , Hiper-Reatividade Brônquica/diagnóstico , Testes de Provocação Brônquica/normas , Acetilcolina/administração & dosagem , Relação Dose-Resposta a Droga , Humanos , Pneumoconiose/diagnóstico , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
Non-specific immunological parameters were analysed in dependence of cigarette smoking. Although the serum protein levels were in the normal range, it was remarkable to find some differences between non-smokers, ex-smokers and (heavy) smokers. These differences are especially distinct in the mean levels of IgE, alpha 1 PI and ceruloplasmin.
Assuntos
Pneumopatias Obstrutivas/imunologia , Fumar/imunologia , Adulto , Proteínas Sanguíneas/metabolismo , Humanos , Tolerância Imunológica/imunologia , Imunoglobulinas/metabolismo , Medidas de Volume Pulmonar , Masculino , Pessoa de Meia-Idade , Fumar/efeitos adversosRESUMO
Preparing a special occupational health follow-up a cross sectional study in 304 dust exposed workers was performed. According to these screening results 23% of the workers examined revealed as fit only under special conditions. Clinical examinations confirmed these judgements except a small group of 2.9%. In confirmed cases hygienic measures in regard of the working places and/or medical treatments were started. Effectivity will be studied in a longitudinal manner.
Assuntos
Poeira , Exposição Ambiental , Pneumoconiose/epidemiologia , Adulto , Carvão Mineral , Estudos Transversais , Humanos , Masculino , Radiografia Pulmonar de Massa , Pessoa de Meia-Idade , Pneumoconiose/diagnóstico , Radiografia Torácica , Testes de Função RespiratóriaRESUMO
Starting from diagnostic relevance of non specific bronchial challenges the principles and experiences of a screening type acetylcholine test which is recommended as a standard in GDR since 1974 are discussed. For special tasks like longitudinal studies and clinical pharmacology a threshold method using histamine was derived and modified from literature. Special attention is paid to diagnostic, prognostic and expertizing relevance of non specific bronchial hyperreactivity.
Assuntos
Asma/diagnóstico , Testes de Provocação Brônquica/métodos , Pneumopatias Obstrutivas/diagnóstico , Resistência das Vias Respiratórias , Volume Expiratório Forçado , Alemanha Oriental , HumanosRESUMO
The case of a 57-year-old man is reported, who worked as a plasma welder about 15 years. Chronic recurrent bronchitis was diagnosed 12 years after beginning of this work. The patient changed the place of his employment but the course of disease was uncommonly progressive. He died of right ventricular heart failure 10 years later. One year before death, the chronic obstructive pulmonary lesions were acknowledged as occupational disease. The post-mortem histological and chemical analysis of lung tissue yielded a mixed dust pneumoconiosis. These findings supported additionally the diagnosis of occupational disease.
Assuntos
Poeira/efeitos adversos , Pneumopatias Obstrutivas/patologia , Pneumoconiose/patologia , Soldagem , Humanos , Pulmão/patologia , Masculino , Metais/análise , Pessoa de Meia-IdadeRESUMO
Formulas for calculation of total lung capacity from chest X-rays were compiled from literature. Using the total lung capacity measured by bodyplethysmography as reference, these formulas and several modifications were tested for usefulness. The product of lung area in the posterior-anterior X-rays and the largest diameter from sternum to the dorsal rib bow in the frontal X-rays was the most simple and exact roentgenological indicator of total lung capacity. 95%-confidence intervals for predictive values gained by this method revealed to be of similar range as for total lung capacity estimated by the gas dilution methods in comparison to bodyplethysmography.
Assuntos
Pletismografia Total/instrumentação , Pneumoconiose/diagnóstico por imagem , Capacidade Pulmonar Total/fisiologia , Adulto , Idoso , Humanos , Medidas de Volume Pulmonar , Pessoa de Meia-Idade , Radiografia , Valores de ReferênciaAssuntos
Poluentes Ocupacionais do Ar/efeitos adversos , Cocarcinogênese , Pneumopatias Obstrutivas/etiologia , Neoplasias Pulmonares/etiologia , Doenças Profissionais/etiologia , Fumar/efeitos adversos , Adulto , Feminino , Alemanha Oriental , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de RiscoAssuntos
Poluentes Ocupacionais do Ar/efeitos adversos , Carcinoma Broncogênico/induzido quimicamente , Cromo/efeitos adversos , Neoplasias Pulmonares/induzido quimicamente , Níquel/efeitos adversos , Doenças Profissionais/induzido quimicamente , Fibrose Pulmonar/induzido quimicamente , Soldagem , Humanos , Fatores de RiscoRESUMO
Reference values of the maximal expiratory flow-volume curve for the adult GDR's population have been ascertained by a co-operative study of 5 lung function laboratories. We analysed measurements in 1,004 healthy subjects aged 16 to 69 years (728 males and 276 females). Prediction equations for the maximal expiratory flow rates, several time constants of lung mechanics and screening parameters of ventilatory inhomogeneity have been calculated by means of the multiple linear regression analysis. Our reference values are in good accordance with SEPCR summary equations. It is recommended to subtract from or add to the predicted values 1.64 standard deviations and to consider abnormal all values beyond this limit.
Assuntos
Fluxo Expiratório Forçado , Pico do Fluxo Expiratório , Respiração , Adolescente , Adulto , Idoso , Feminino , Alemanha Oriental , Humanos , Masculino , Pessoa de Meia-Idade , Valores de Referência , Análise de RegressãoRESUMO
56 electric arc welders found in a cross-sectional study to show pulmonary siderosis in full size x-rays were clinically examined. Looking for the discussed functional, relevance of such lung diseases in welders the diagnostic program included spirometry, flow-volume-curves, body-plethysmography, single breath diffusion capacity, pulmonary compliance and ergooxytensiometry. The results are supporting that "lung siderosis" in welders is associated with slight functional deterioration in the type of interstitial lung diseases.